Just When You Thought You'd Seen It All.

Bagel heads? What the hell?

National Geographic's new television series Taboo has shed light on the bizarre Japanese trend for “bagel heads”. Japan is the locus of weird. Especially in places like Tokyo, where you're compacted in with millions of other people, if you want to look like an individual the standards are HIGH.

Supposedly, the increasingly popular procedure is done by injecting saline into the forehead, then pressing in the center of the swollen area with a thumb. It’s temporary, so your “bagel” absorbs into your body after 6 to 24 hours, and that’s a good thing – no bagel-headed grandmas will be walking around in 50 years.

I can't see that you need to run out and sign up for any training on how to do this...

Limiting Options Can Boost Your Medical Spas Sales

When you're trying to be everything to every one, too many options will actually cost you.

We make choices daily, may it be major or minor. We desire choices which we can differentiate and evaluate. But presenting individuals an abundance of choices do not necessarily equate to happier consumers. Consequentially, if you happen to be providing your medical spas clients or patients with too much choices, it will almost always hurt your conversion rates.

Choices have repercussions on the brain. As a matter of fact, some studies revealed that having to come up with a lot of decisions can leave people exhausted, mentally drained and more dissatisfied with their decisions. On top of that, it leads people to commit poorer choices -- sometimes at a time when the choice is crucial. Even if we choose well, we are often less content because, with so many choices, consumers are certain that somewhere out there was something much better. We experience doubt and uncertainty about the alternatives and we ponder about missed opportunities.

The same is applicable to your clinic. Your lits of services and pricing should be simple, straightforward and uncomplicated. If you want to increase form conversions, you must think about eliminating the number of options, not continually increase them. An easy experience shows users that you have enough options to choose from, and allows them to make comparisons that are relatively easy.

In fact, offering fewer options quickly lead to many more profits:

• You're able to spend your patient markeing budget on fewer items.
• Your staff can spend less time trying to talk about everything you can do, and talk about the benefits of the things that you already do.
• You probably don't have to buy more technology.
• Your patients can make clearer choices, and feel better about their decisions.
• You sound more credibile and 'expert' in the area.

Limiting your menu of services and focusin your offering on a few key offerings gives you many benefits, and few drawbacks. If you offer everything you'll never be seen as being an expert in anything.

Awesome Plastic Surgery Commercial?

Rhett & Link make local commercials (and they've turned their attention to plastic surgery).

These guys have millions of views on their YouTube channel. In these videos they show a 'behind the scenes' making of and then the actual videos.

You have to give it to Dr. Timothy Kelley there... that's not what you normally see, but the proofs in the 621k+ views... something's working there.

The Beauty and the Buzz at ASLMS

Just like many of you, my day is scheduled from morning to night and I am lucky if I can grab a bite to eat in between patients. It’s a real challenge to carve out time for professional development (and lunch). That’s why I appreciate the annual conferences hosted by the professional organizations. I can block out that time months in advance knowing that I will come back with new ideas.  

The American Society for Laser Medicine & Surgery (ASLMS) is on my must attend list year after year. It’s probably the best in the world for exchanging ideas and real science in the world of aesthetics, and not just marketing hype.

This year was no different. The 2014 meeting held in Phoenix, AZ was full of ideas. So many ideas that I wish I had a longer flight home to research them all.

When I returned my staff asked “What was the highlight”? The truth is there were so many highlights. I came home with so many pearls of wisdom about so many different areas of practice. I’d like to share a few of them with you.

Privacy Laws    
This year brings changes in HIPAA privacy and security rules. There are new rules addressing the sale of protected health information for marketing and fund raising purposes. There are new rules surrounding business associates that you contract with. There are also new waves of audits to ensure compliance. The meeting was a call to action to get my staff prepared for the new guidelines.
Under Eye Bags
For those of you not familiar with Neotensil, I suggest you take a look. It is a new film-like substance, made by a hair care line Living Proof, which reduces the appearance of undereye bags. It’s sold through physicians’ offices, but applied by the patient at home.  
Injectable Filler Technique
Take that extra care, that extra wipe step, with Voluma and other facial fillers. When injecting fillers in the hollows of the lateral orbit, think microcannulas with a lateral point temple zygomatic point of entry.  And on those crow’s feet, think of almost individual dosing per severity of lines at those two to three lateral orbit injection points. I also learned about pre-injection disinfecting wipe pads that combine clorhexidine with isopropyl alcohol.
Acne Suppression
There was a lot of buzz about keeping acne at bay using combinations of both short pulsed and long pulsed YAG lasers. It seems a paradox, but patients did better long term when they did laser acne treatments after finishing a course of antibiotics.  For patients with unresponsive rosacea pustular acne, think SIBO or small intestinal bacterial overgrowth and order a lactulose breath test screen.  
Bruising
For that post treatment unintended or inconvenient bruise, think of speeding up its disappearing act with an IPL treatment about 2 days after.  
Tattoo Removal
Here is a tip for tattoo removal for those of you not yet into Picosecond lasers. Treat the area through a hydrocolloid dressing, such as Second Skin.  
Noninvasive Fat Removal
There was a ton of chatter, all of it exciting, about noninvasive fat removal. The players are CoolSculpting,  Liposonix and the newest kid on the block, Vanquish.

Some of the above ideas are reality for me. We added Vanquish to our list of noninvasive fat removal a few months back. It’s a great fit for our practice and patients. Other ideas may not be a fit. But that’s the beauty of the meeting. With so many new products and protocols shared in one space, you are bound to come back with ideas to push your practice forward.  

Right Size Your Medspa Info & Pricing

Next time you're in the consultation room... remember this graphic.

Question: Are Female Doctors Better Than Male Ones?

A new study from the University of Montreal finds that there may be real differences between the care provided between female and male doctors, and that women outperformed men on certain metrics of patient care.

Valérie Martel, a masters candidate in the school’s department of health administration, Régis Blais, a professor in the department, and Roxanne Borges Da Silva, a professor of nursing, recruited 870 Quebec-based physicians—half men, half women—treating people with diabetes. To compare if a doctor’s gender affected patient behavior, the researchers evaluated  physicians on three parts of standard diabetes treatment: prescribing periodic eye exams, scheduling frequent physical check-ups and keeping their patients on some mix of three different medications, such as statins to control cholesterol. On all of the metrics, the female doctors beat the males. Other research has found that female doctors tend to show greater empathy are perceived as being better listeners.

The men tended to spend less time with their patients, as evidenced by the fact that the male physicians performed, on average, 1,000 more basic treatment procedures per year than their female counterparts.

The Montreal investigators plan to broaden their findings, looking at three other manageable conditions next: hypertension, asthma and chronic obstructive pulmonary disease (COPD), to see if the gender-based difference applies to other conditions as well.

Male doctors shouldn't pack up their doctor kits just yet. The younger the doctors in their study were, the narrower the divide between the sexes, suggesting that hurry-up male doctors are aging out of the system, being replaced by a newer, gentler generation of male clinicians.

Question: Will new patient ratings and outcome reimbursment triggers affect this?

My breasts are cold!!

“My breasts are cold!!” said a patient of mine in her last postop visit. We did a breast augmentation with saline implants just a few weeks ago, and her postop recovery has been smooth and uneventful. It’s been an unusually cold winter this year, with Arctic blasts and heavy snowstorms, so this kind of complaint shouldn’t be surprising. I guess my southern colleagues and readers have already tuned out, I don’t remember my plastic surgeon buddies in Miami complaining about any snow, but they don’t only do breast implants in Miami you know…

Cosmetic plastic surgery, being elective in nature, is always risky business. We surgeons take the utmost effort to warn our patients about all reasonable risks and alternatives to our various procedures. But, “your breasts might feel cold when it’s cold outside” is usually not part of my consultation. In the grand scheme of things, unless you find yourself in the perfect storm of running a saline implant breast augmentation private practice in Alaska, cold breasts are probably down at the bottom of your risk list. But it is an interesting phenomenon that happens due to the specific heat of water – greatest of all substances known to man. Water, which is for all intents and purposes the major component of saline, can absorb lots of energy, and thus, is hard to heat and hard to cool. Consequently, when it’s cold outside, your saline breast implants are going to get cold. And the bigger the implants, the colder you’ll be. Now once they get cold, it’ll take just as much time in warm weather, indoors or outdoors, for them to warm up.

I find it hard enough to go thru the list of relevant risks as it is, but I suppose as long as we have cold weather and saline breast implants, cold implants are a relevant risk. Now, when I mention it in my consultations, I get more chuckles from my patients than anything else. So, I suppose that little bit of comic relief is a good effect in what is, in the least, an arduous process of informed consent. Now back to all this cold winter weather, I suppose it’s just global warming….

Daniel Kaufman, MD
Discreet Plastic Surgery 

Why I Quit Medical School

Why would you not want to become a physician in America?

Jeremy was familiar with life as a doctor. His father's a maxillofacial surgeon. So is his brother who's just a year or two older. Here's Jeremy's post on why he quit medical school and decided not to become a doctor. Jeremy blogs at Never Eat Soggy Waffles

It hit me. Sometime around the time I was filling out my secondary application for medical school during my senior year in college… it hit me. It felt less like a swift slap to the face and more like a creeping, slinking hollowness… perhaps akin to a small but persistent elephant sitting on my chest. We’ll call him Chester. I would be able to shake this persistent pachyderm for days, perhaps weeks at a time, but he would always return. Scramble up my leg, nestle down just below my left collarbone and take a nap. Deep breaths wouldn’t make him go away.  Long runs wouldn’t shake him. Most of the time he was barely perceptible, but present nonetheless. Doubt.

Excitement and Doubt

The acceptance letter came. Rejoicing ensued. But halfhearted, fraught with thinly veiled concerns and flimsy self-assurances that this was the path I was destined to take. The letter was like a steroid injection to my ego and my newly muscled ego chased Chester away for a month or two. If medical school wants you, how can you say no to medical school. It’s a privilege, an honor even, to be one of the few and the proud… and it genuinely was. And yet, after the newness had worn off, Chester slowly slunk back to his customary perch. Doubt.

The crazy plan…

It was around Christmas break of this same senior year that my friend Bjorn Harboldt shared with me his seemingly laughable plan to travel from one end of the world to the other… in a year… quite literally. His plan was to start at the furthest southern city in South America Ushuaia in Cape Horn. Travel up through South America, Central America, and North America to Alaska. Find a way across the Pacific Ocean. Continue through Asia, up into and across Siberia to Eastern Europe. Down through Eastern Europe to the ancient shores of the Mediterranean. Cross that sea and traverse Africa to the farthest southwestern corner and the Cape of Good Hope. Quite ludicrous. Ostentatious even. A truly excessive bit of traveling.

“to live a year intentionally…”

At the mere mention of this trip Chester fled. My heart beat with a strong and assured thud at the thought of such an adventure. I did not have delusions that this trip would drastically change anything. I didn’t believe that I would “find” myself because I didn’t really feel lost. I didn’t believe that the trip even made “sense” in the traditional “sense” of the word. My parents and many friends thought that I had perhaps been given over to depravity of a most irresponsible, albeit innocent, sort. My thoughts were simply that this is what I wanted out of life. To broaden my perspective, to live adventure instead of only talking and dreaming about it, to follow the strong and clear thud of my heart, to live a year intentionally instead of following the prescribed plan, to take ownership of my actions.

Although I usually oscillate precariously over weighty decisions… It didn’t take me long to lay my cards on the table and tell Bjorn that I was “all in.”

Planning, saving, selling possessions, successfully attempting to get companies to give us equipment and unsuccessfully getting companies to give us money, getting medical school deferrals, graduating from college, packing, dreaming. It all happened so quickly. And then suddenly… we were getting off the plane in Chile with packs on our back, no reservations, and no real plan except to get to the Cape of Good Hope.

“It opened me up to options and ways of existing that my narrow mid-American worldview would never have even entertained.”

Traveling around the globe by any means possible…

I will not regale you with the details as they can be read at http://www.thewholeworldround.wordpress.com. Suffice it to say that that year of mad capped traveling opened me up to a more global way of thinking. It opened me up to options and ways of existing that my narrow mid-American worldview would never have even entertained. I met people who were living, really living. Not just talking about pedaling a bike from Istanbul to Vietnam, actually doing it. Not just talking about riding a motorcycle from Boston to the bottom of South America, actually doing it. Not just talking about opening up a little hostel in Thailand…. Actually doing it. I met a lot of dreamers… that were actively turning their dreams and interests into realities.

The open road… the ultimate education.

First year of medical school

Chester was mostly absent during this year of exploration. The next time he showed up was the summer after I returned from the trip. He stayed with me all the way through the first year of medical school. He grew into a full-blown tusker of doubt. Doubt about the path I had taken. All the while I created a million well-crafted reasons why I was on the right path. People around me re-enforced this thinking. My own ego re-enforced this thinking. The self-denial was spread thick. I almost dropped out at Thanksgiving break, at Christmas break, at spring break, but my carefully constructed rationalizations kept me around until the end of the year.

It was around this time that I met Lindsay. She is now my wife. I did some hardcore re-assessing during this summer between my first and second years of medical school. I went to an intensive, interactive self-improvement workshop. I read a lot. I prayed a lot. I began telling myself the truth. I did some very hard and very personal growth work. And then second year medical school began….

“I realized that my life was not going where I wanted it to go.”

Two weeks in it all came to a head. The thin veil was lifted. I stopped lying to myself. There were no more rationalizations. I realized that I was in a place I didn’t want to be in. I realized that my life was not going where I wanted it to go. As strange as it sounds, I realized I had gotten there by default. I had gotten there by letting life happen to me. I was not happy. So I made a very difficult decision… I quit medical school.

“…taking ownership for my future instead of just floating towards a sensible default.”

I wish I could say that my life purpose instantly crystallized and it has been all rainbows and sunbeams since I made that decision, but that wouldn’t be true. There was an instant flood of relief once the decision was made, but it has been difficult to let go. To picture myself in the future as something other than a medical doctor. To start taking ownership for my future instead of just floating towards a sensible default. To take steps toward living more wholeheartedly. At some point during this process I realized that Chester was shrinking. Taking ownership for my path in life was causing the change.

Lindsay was with me through the whole process of leaving medical school. She was with me through the doubts, the valleys, the indecision, the oscillating, and even the tears. Six months after dropping out of medical school we were engaged.  Three months after that we were married. We had a lot of long talks and earnest prayers about what we wanted our life together to be like. Global development and humanitarian work was at the core of who we both were. We both love to travel. So we made the decision together before we even got married to do a Master’s in Global Community Development that would begin the fall after we got married. We decided to follow our interests and take ownership for our path. We decided to attempt to turn those interests into a sustainable livelihood. We decided to do this together.

I am writing this from Arusha, Tanzania. I am sitting next to my wife in a little bungalow on the grounds of the Colobus Lodge. We are in the second semester of our Master’s program. We are preparing to go to a rural World Vision project to work on building the capacity of the local office and community there. I can say with complete integrity that this Master’s program is the most fulfilling formal education I have ever had. We have some awesome prospects for international internships. I am seriously considering doing a PhD in International Development. The possibilities seem endless.

I don’t recall the last time Chester was home.